Esophageal Rupture: Diagnosis by Pleural Fluid pH

Failure to appreciate the significance of a pleural fluid pH of 5 led to delay in establishing a diagnosis of esophageal rupture. In a subsequent study the pH of 56 pleural fluid specimens from 50 patients with conditions other than esophageal rupture was determined. In no case was the pH less than 6. While a pleural fluid pH of 6 or greater may be associated with a variety of conditions, a value less than 6 is highly suggestive of esophageal rupture.